Abstract
Objectives
To assess in Veterans with spinal cord injury (SCI) or amputated limb (AL) the following:
(1) patient demographics, medical factors, cultural and psychosocial characteristic
by race; (2) wheelchair quality by race; and (3) the independent associations of patient
race and the other factors with wheelchair quality.
Design
Cross-sectional cohort study.
Setting
Three Department of Veterans Affairs (VA) medical centers affiliated with academic
medical centers.
Participants
Eligible participants were Veterans with SCI or ALs (N=516); 482 of them completed
the interview. Analyses were restricted to white and African American participants.
Because there was no variation in wheelchair quality among AL patients (n=42), they
were excluded from all but descriptive analyses, leading to a final sample size of 421.
Interventions
Not applicable.
Main Outcome Measure
Wheelchair quality as defined by the Medicare Healthcare Common Procedure Coding System.
Results
We found race differences in many of our variables, but not in quality for manual
(odds ratio [OR]=.67; 95% confidence interval [CI], .33–1.36) or power (OR=.82; 95%
CI, .51–1.34) wheelchairs. Several factors including age (OR=.96; 95% CI, .93–.99)
and income (OR=3.78; 95% CI, 1.43–9.97) were associated with wheelchair quality. There
were no significant associations of cultural or psychosocial factors with wheelchair
quality.
Conclusions
Although there were no racial differences in wheelchair quality, we found a significant
association of older age and lower income with poorer wheelchair quality among Veterans.
Efforts are needed to raise awareness of such disparities among VA wheelchair providers
and to take steps to eliminate these disparities in prescription practice across VA
sites.
Keywords
List of abbreviations:
AL (amputated limb), CI (confidence interval), OR (odds ratio), SCI (spinal cord injury), VA (Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 03, 2016
Footnotes
Supported by the Rehabilitation Research and Development Department of the Veterans Affairs (grant no. B7148I). The contents do not represent the views of the Department of Veterans Affairs or the United States Government.
Clinical Trial Registration No.: NCT01236170.
Disclosures: none
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
